Lactosylceramidase assays for diagnosis of globoid cell leukodystrophy and GM1-gangliosidosis

A case of Krabbe's leukodystrophy without globoid cells

Krabbe's globoid cell leukodystrophy is a rare hereditary progressive neurological disease of infants, in which there is deficient activity of galactosylceramide beta-galactosidase. The pathological hallmark is the presence of multinucleated globoid cells in the white matter associated with severe myelin depletion and gliosis. We report a second case where galactosylceramide beta-galactosidase deficiency was proven but no globoid cells were found in the brain. Symptoms began within the first 10 months of life and a deficiency of galactosylceramide beta-galactosidase activity was demonstrated in peripheral blood leukocytes and skin fibroblasts. The child survived till 8 yrs 7 mths. The reason for the absence of globoid cells is not clear but may be related to different effects of the gene mutation on the four substrates or possibly the interaction of sphingolipid activator protein-2.

Optimal assay conditions for enzymatic characterization of homozygous and heterozygous twitcher mouse

The neurological mouse mutant twitcher is characterized by a genetic deficiency of galactosylceramide beta-galactosidase (galcerase) (EC 3.2.1.46) which also represents lactosylceramide beta-galactosidase I (lactosidase I) activity. The assay conditions for both these activities in several mouse tissues have been optimized to facilitate the enzymatic characterization of homozygous and heterozygous twitcher mice. Galcerase in mouse tissues is optimally activated by 7.0 mg/ml of sodium taurocholate (pure) and 1.5-2.0 mg/ml of oleic acid in this system. When lactosylceramide is used as the substrate, no more than 1 mg/ml of taurocholate is appropriate in the assay, since higher concentrations of this pure bile salt stimulate another enzyme, lactosylceramide beta-galactosidase II (lactosidase II), which is unaffected in twitcher mice. At the optimized condition, lactosidase I in the twitcher mouse amounts to 3-4% of control activity in agreement with the residual galcerase (2%) in this mouse mutant. These assay conditions provide better sensitivity to discriminate heterozygotes from controls until 40 days of age from measurement of this activity in clipped tail samples.

Chronic GM1 gangliosidosis presenting as dystonia: II. Biochemical studies

A patient with chronic GM1 gangliosidosis was studied enzymatically and biochemically. Leukocyte acid beta-galactosidase activity was severely deficient. In brain and liver, the 4-methylumbelliferyl beta-galactosidase with acidic pH optimum and lactosylceramidase II were deficient while other hydrolases were present in normal amounts, including sialidase determined with N-acetylneuramin-lactose and fetuin as substrates. Neutral beta-galactosidase in liver was increased up to fourfold over the control. Corresponding to the pathological findings, GM1 ganglioside sialic acid was increased in the basal ganglia to 57% of the total (normal, 12 to 16%), accounting for the rise in total ganglioside to 180% of normal in this origin. Only slight to moderate elevations in the proportion of GM1 ganglioside were noted in the cerebral cortex and white matter, without major increase in total ganglioside. Elevated asialo GM1 ganglioside was also confined to the basal ganglia. There was no increase in hepatic glycoproteins or in keratan sulfate-like materials. This is the only known patient with chronic GM1 gangliosidosis in whom abnormal accumulation of GM1 ganglioside has been demonstrated in affected tissue and sialidase deficiency has been excluded as the primary genetic defect.

The Twitcher mouse: an enzymatically authentic model of human globoid cell leukodystrophy (Krabbe disease)

The Twitcher is a new neurological mutant of mouse which shows clinical and histopathological features similar to those of human and canine globoid cell leukodystrophy (Krabbe disease). Brain and liver tissues of affected mice showed a profound deficiency of galactosylceramidase and lactosylceramidase I activities. A distinct group with intermediate enzyme activities could be identified among the phenotypically normal mice, consistent with their being heterozygotes. The Twitcher mouse is, therefore, not only a clinically and morphologically, but also an enzymatically, authentic model of human globoid cell leukodystrophy. This is the first enzymatically authentic murine model of human sphingolipidosis.

Specificity of galactosylceramidase activation by phosphatidylserine

Bovine brain phosphatidylserine effectively activates human brain galactosylceramidase (Hanada, E. and Suzuki, K. (1979) Biochim. Biophys. Acta 575, 410-420). Its effect on the other beta-galactosidase (Gm1-ganglioside beta-galactosidase) in human tissues, genetically distinct from galactosylceramidase, was examined. When partially purified human brain beta-galactosidase preparations, pure with respect to each other, were used as the enzyme source and when lactosylceramide, a common glycosphingolipid substrate for both beta-galactosidases, was used as the substrate, phosphatidylserine activated only hydrolysis of lactosylceramide by galactosylceramidase but not by GM1-ganglioside beta-galactosidase. With either galactosylceramide or lactosylceramide as substrate, and with phosphatidylserine as the activator, diagnosis of globoid cell leukodystrophy was possible using whole homogenates of cultured fibroblasts. Since 80-90% of lactosylceramide-cleaving activity in normal fibroblasts is due to GM1-ganglioside beta-galactosidase and since fibroblasts of globoid cell leukodystrophy patients are genetically deficient in galactosylceramidase but normal in GM1-ganglioside beta-galactosidase, these rsults are also consistent with specific activation of galactosylceramidase by phosphatidylserine.

Enzymic hydrolysis of sphingomyelin in the presence of bile salts

Sphingomyelin in mixed dispersion with bile salts was hydrolysed by the solubilized sphingomyelinase of rat brain lysosomes. In parallel studies, physical properties of these dispersions were determined. The kinetic curves that described the rate of hydrolysis as a function of increasing concentrations of bile salt were multiphasic. A region of very low activity was followed by an ascending portion, a peak, a descending portion, a trough and a second ascending portion. The positions of the initiation points, peaks and troughs were found to be a function of the respective ratios of the bile salt to sphingomyelin for the detergent sodium taurodeoxycholate, but of the absolute concentration of the detergent for sodium taurocholate. Turbidity studies suggested that hydrolysis of sphingomyelin begins at a bile salt concentration that solubilizes the lipid and incorporates it into a mixed micelle with the detergent. Ultracentrifugation studies suggested that the sizes of the mixed aggregates of detergent and lipid were a function of the ratio of taurodeoxycholate to sphingomyelin, but of the absolute concentration of the bile salt, for sodium taurocholate.

A comparison of the properties and bile salt specificities of galactosylceramide and lactosyl ceramide beta-galactosidase activities in human leucocytes and fibroblasts

The properties and bile salt specificities of galactosylceramide and lactosylceramide beta-galactosidase activities (GC and LC-beta-galactosidases) of human leucocytes and fibroblasts were compared. A number of differences were observed. Under the standard assay conditions the former activity was more sensitive to Zn2+ and Triton-X100. Glycocholate and cholate were more active stimulators of the GC-beta-galactosidase than the more frequently used taurocholate which was the most effective stimulator of LC-beta-galactosidase activity. It is postulated that some of the apparent differences in the properties of GC- and LC-beta-galactosidase activities may be attributed to the different micellar properties of the lipid substrates. Experiments with fibroblasts from patients with Krabbe's disease confirmed an almost total absence of GC-beta-galactosidase whichever bile acid was employed. Residual LC-beta-galactosidase activity detected in these cells was much higher ranging from 13% of the lowest measured value when measured with taurocholate to approximately normal values with glycocholate. Fibroblasts obtained from patients with GM1-gangliosidosis displayed close to normal GC and LC-beta-galactosidase activity under our experimental conditions. The data suggest that diagnoses of Krabbe's disease should be performed with galactosylceramide rather than lactosylceramide as substrate.

Human brain cerebroside beta-galactosidase: deficiency of transgalactosidic activity in Krabbe's disease

Under experimental conditions optimal for the assay of D-galactosyl-N-acylsphingosine galactohydrolase (EC 3.2.1.46) activity, homogenates of neurologically normal human brain tissue could transfer galactose from galactosyl ceramide (gal-cer), lactosyl ceramide (lac-cer), 4-methylumbelliferyl-beta-galactoside (4-MU-gal), or p-nitrophenyl-beta-galactoside (PNP-gal) to [1-14C]oleoyl sphingosine, but homogenates of brain tissue from patients with Krabbe's disease lacked this ability. The rate of hydrolysis of ganglioside GM1 and, to a lesser extent, of PNP-gal by homogenates of Krabbe's brain tissue was also decreased. Activity of PNP-beta-galactosidase in normal brain tissue, like that of cerebroside beta-galactosidase from the same source, was considerably more heat-stable than the activity of either 4-MU-beta-galactosidase or the predominant GM1 beta-D-galactosidase (EC 3.2.1.23). Lac-cer and GM1, as well as 4-MU-gal and PNP-gal, were competitive inhibitors of human-brain cerebroside beta-galactosidase. These findings confirm the ability of mammalian cerebroside beta-galactosidase to catalyze a transgalactosylation reaction and provide additional information on the substrate specificity of human brain cerebroside beta-galactosidase.

Globoid cell leukodystrophy (Krabbe's disease). Metabolic studies with cultured fibroblasts

Metabolism of tritium-labelled galactosylceramide and lactosylceramide added to the culture medium was examined in cultured skin fibroblasts from 4 patients with globoid cell leukodystrophy (GLD) and 4 control individuals. The uptake of [3H]galactosylceramide and [3H]lactosylceramide by the fibroblasts continued actively at least up to 3 days. Approximately 30--40% of the galactosylceramide, which had been taken up, was released subsequently from the cells in a 4-day period, whereas only 10% of lactosylceramide was released during the same period. The GLD fibroblasts showed no abnormality in the kinetics of the uptake and in the release of these glycosphingolipids which are natural substrates of the beta-galactosidase genetically deficient in the disorder. This finding differs from that reported for fibroblasts from patients with metachromatic leukodystrophy, which showed abnormal accumulation and retention of sulfatide added to the culture media. However, degradation of added galactosylceramide to [3H]galactose by the GLD fibroblasts was only 25% of the control cells, while lactosylceramide was degraded at 70% of the normal rate. These findings are consistent with the known substrate specificities of the two acidic beta-galactosidases in human tissues; galactosylceramide is hydrolyzed almost exclusively by galactosylceramidase, while lactosylceramide can be hydrolyzed by both galactosylceramidase and GM1-ganglioside beta-galactosidase.

Use of a chromogenic substrate for the diagnosis of Krabbe's disease, with special reference to its application in prenatal diagnosis

A chromogenic substrate, 2-hexadecanoylamino-4-nitrophenyl-beta-D-galactopyranoside, has recently been described for the diagnosis of Krabbe's disease. Hydrolysis of this substrate by extracts of cultured cells and tissues was compared with the activities of lactocerebrosidase I and non-specific beta-galactosidase. Under appropriate conditions, hydrolysis of the chromogenic analogue was markedly reduced in extracts of cultured amniotic fluid cells and skin fibroblasts derived from cases of Krabbe's disease. Activity was also markedly deficient in extracts of Krabbe's brain, although only a partial reduction was measured in liver extracts. Generally activities were higher in tissues of fetal origion. Unfortunately, the new analogue proved less specific and less sensitive than the natural substrates used to diagnose Krabbe's disease. Consequently, the analogue does not provide a satisfactory alternative substrate for the prenatal diagnosis of Krabbe's disease.

The two human lactosylceramidases and their respective enzyme activity deficiency diseases: inhibition studies using p-nitrophenyl-beta-D-galactoside

Total lactosyl ceramide beta-galactosidase (LC) activity from normal and pathologic human leukocytes and tissues was subdivided into LC I (EC 3.2.1.46) and LC II (EC 3.2.1.23) activity by means of specific inhibition of LC II with 5 mM p-nitrophenyl-beta-D-galactoside (Ki = 1.5 mM). In globoid-cell leudodystrophy, inhibition of total LC was nearly complete (only LC II is active), whereas in GM1-gangliosidosis Type 1, very little inhibition was found (only LC I is actict). Total LC activity was not significantly low in either of the diseases, which have different genetic origins. The ratio of LC I to LC II activity may display remarkable genetic variation in normal probands.

Diagnosis of the sphingolipidoses with labelled natural substrates

The genetic heterogeneity of sphingolipidoses is underlined and the desirability of using natural labelled substrates for the diagnoses of each new index case strongly emphasized. Recent studies of our Scandinavian Krabbe families (more than 50) have repeatedly shown that there is no method developed which can be used for the detection of carriers of the mutant gene in leukocytes or lymphocytes. Also described are enzymic studies in two forms of Gaucher disease which further demonstrate the importance of natural substrates for the diagnoses of the disease in leukocytes and cultivated amniotic fluid cells.

Glycosphingolipid hydrolases: properties and molecular genetics

This is a review of the properties and molecular genetics of six lysosomal hydrolases: beta-galactosidase, hexosaminidases A and B, alpha-galactosidase, beta-glucosidase and alpha-fucosidase. Each enzyme is discussed with regards to isoenzymes and substrate specificity, subunit structure, genetic relationship of isoenzymes and genetic variants. The molecular genetics of human diseases caused by deficiencies of each enzyme are discussed.